椎弓根钉内固定联合腰椎间盘摘除椎间Cage植骨融合术治疗腰椎滑脱患者的疗效

Clinical Effect of Pedicle Screw Internal Fixation Combined with Intervertebral Cage Graft Fusion for Lumbar Spondylolisthesis

目的探讨椎弓根钉内固定联合腰椎间盘摘除椎间Cage植骨融合术治疗腰椎滑脱患者的疗效。方法选取2017年5月至2019年4月庆阳市人民医院收治的100例腰椎滑脱患者,将其按照姓氏拼音首字母进行顺序编号,随机分为对照组和研究组,各50例。对照组在椎弓根钉内固定基础上联合单纯椎间植骨术治疗,研究组在椎弓根钉内固定基础上联合Cage椎间植骨术治疗。比较两组患者的治疗效果,血清肌酸激酶(CK)、C反应蛋白(CRP)水平,Oswestry功能障碍指数(ODI),日本骨科协会评估治疗评分(JOA),疼痛数字评分(NRS)及并发症发生情况。结果研究组治疗总有效率(98.00%)高于对照组(86.00%),差异有统计学意义(P<0.05);研究组血清CK[(171.00±5.51)U/L]、CRP[(13.20±2.65)mg/L]水平明显低于对照组[(31.65±3.85)mg/L,(248.54±8.95)U/L],差异均有统计学意义(均P<0.05);研究组ODI指数(15.22±1.10)低于对照组(24.85±2.64),JOA评分(20.65±2.83)高于对照组(15.11±1.33),差异均有统计学意义(均P<0.05);研究组NRS评分(3.15±1.55)低于对照组(5.62±2.04),差异有统计学意义(P<0.05);研究组并发症发生率(6.00%)低于对照组(24.00%),差异有统计学意义(P<0.05)。结论应用椎弓根钉内固定联合腰椎间盘摘除椎间Cage植骨融合术治疗腰椎滑脱患者,既可改善患者的功能障碍,又可提高其治疗效果,减少并发症的发生,且手术安全性较高。

Objective To investigate the efficacy of pedicle screw fixation combined with lumbar disc removal and intervertebral Cage bone graft fusion in the treatment of lumbar spondylolisthesis.Methods A total of 100 patients with lumbar spondylolisthesis admitted to Qingyang People's Hospital from May 2017 to April 2019 were selected and numbered according to the initials of their surnames.They were randomly divided into a control group and a study group,with 50 cases in each group.The control group was treated with simple intervertebral bone grafting on the basis of pedicle screw internal fixation,and the study group was treated with Cage intervertebral bone grafting on the basis of pedicle screw internal fixation.The treatment effects,serum creatine kinase(CK),C-reactive protein(CRP)levels,Oswestry disability index(ODI),Japanese Orthopedic Association Evaluation and Treatment Score(JOA),numerical pain score(NRS)and complications symptoms of the two groups of patients were compared.Results The total effective rate of treatment in the study group(98.00%)was higher than that of the control group(86.00%),and the difference was statistically significant(P<0.05);the study group's serum CK[(171.00±5.51)U/L],CRP[(13.20±2.65)mg/L]level was significantly lower than the control group[(31.65±3.85)mg/L,(248.54±8.95)U/L],the difference was statistically significant(all P<0.05);the study group ODI index(15.22±1.10)was lower than the control group(24.85±2.64),the JOA score(20.65±2.83)was higher than the control group(15.11±1.33),the differences were statistically significant(all P<0.05);the study group’s NRS score(3.15±1.55)was lower than the control group(5.62±2.04),the difference was statistically significant(P<0.05);the complication rate of the study group(6.00%)was lower than the control group(24.00%),the difference was statistically significant(P<0.05).Conclusion The application of pedicle screw fixation combined with lumbar disc removal and intervertebral Cage bone graft fusion for the treatment of lumbar spondylolisthesis can not only improve the patient’s dysfunction,but also improve the treatment effect,reduce the occurrence of complications,and have a relatively safe operation high.